Where is the wildfire?

One of the amazing aspects to the occupy Wall Street movement is the spread. The movement has gone from a few on Wall Street to thousands in other cities nationally. As of yesterday, the Occupy Wall Street movement is in 25 cities. A gentleman on NPR recently described the movement like “wildfire”. Granted, there are just as many reasons why a movement like this can gain traction and momentum as there are reasons why movements like this lose traction.

“We must understand – at least metaphorically – the half-lives of revolutions. The better we understand them, the better equipped we shall be in their formation, direction and sustenance. The questions are: Where is it coming from?; What’s its energy?; Whereto does it hither?; and What will be the sources of its nourishment? Most importantly: how do we prevent the fate of many revolutions – the all too often disaster of one tyranny replaced by an even more harrowing dystopia?”

Phil is spot on with this one. How well do we, the community, understand what is happening in healthcare?

Community can be defined in so many different ways that for simplicities sake I find it easiest for my work to place community into the following categories: Patient, provider, payer and policy maker. (And yes, I do recognize that it is entirely possible to be more than one of these “categories.”)

It is often said that knowledge alone is not indicative of change. No matter who you are introducing knowledge to, there still must be an attitudinal shift and subsequent behavior change for that knowledge to have had an impact.

Some have written extensively of the role of emotion in change. Without going into all the psychological literature here, let me direct you to a very nicely written Fast Company piece from this past January.

“Knowledge is rarely enough to spark change. People have to want change. Say it’s your job to lure companies to set up shop in Detroit.”

Bringing this full circle, will any attempts to change healthcare fall short as the larger community does not want change? Does the larger community understand what is happening in healthcare, or are we going to continue to ““periodically kick the responsibility for healthcare down the road”? (quote attributed to TR Reid – posted on this site by Dr. Frank Reed)

If we are to sustain revolution and work towards substantive change, we must believe it is important. Phil is right, too many movements lose steam and putter out. So how do we make healthcare more important to the community to want to change?

If we fall back on the health behavior change literature, we know that:

“Studies have also shown that [health behavior] goals are easier to reach if they’re specific (“I’ll walk 20 minutes a day,” rather than “I’ll get more exercise”) and not too numerous (having too many goals limits the amount of attention and willpower you can devote to reaching any single goal). Another recurring theme is that it’s not enough to have a goal: You also need practical ways to reach it. For example, if your goal is to stick to a low-calorie diet, have a plan in place for quelling hunger pangs (for example, keep a bottle of water or cup of tea nearby, or chew sugarless gum).”

Changing healthcare must start with specific changes. What is the “biggest bang for the buck” that we can get?

Changing healthcare must be important to those making the change – this includes each member of the “community”. They all have to want it.

We all have to want it.

Maybe once we have collectively recognized the importance of changing healthcare we will change it.